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Home My WebLink About16289-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. z-16722 Date March 18, 1988 THIS CERTIFIES that the building ....A.L.T.E..R.A.T.! O..N :..R.E..N.O.V.A.T..I.O.N.. ~...A.D.D.I..T.I.O.N. ..... Location o f Property ....5.1.1. 0..0. ?l.a.i..n..Rtl. a..d .............. S.o. ~.~ .t .h .o. 1. d..,. N. ¥. House No. Street Hamlet County Tax Map No. 1000 Section ....0 .7.0 ...... Block 02 . .Lot 07 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..J.u.l.y...2.7.,..!.9.8.7 ..... pursuant to which Building eermit So. 16289 Z dated Ju 1 y 30, 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ALTERATION, RENOVATION & ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.* The certificate is issued to DR. DAVID PASCOE ..................... b¥.'o;, ..................... of the aforesaid building. Suffolk County Department of Health App. r.o~v.al. ~. ~ .~. N / A ~4~uu~ '-'l'l'lJ?8~ ........................... UNDERWRITERS CERTIFICATE NO. N003961 2/5/1988 N/A PLUMBERS CERTIFICATION DATED: Building Inspector *THIS CO IS ISSUED FOR HOI4E OCCUPATION ONLY,. AND MUST BE OIdNER OCCUPIED. Rev. · 0~ NO. ~ TOW'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N*_ 16287 Z Permission is hereby granted to: ............. ............ o'//premises' '~locoted o, ...~..../.~- '-~ ........... ....~..~de~w....~'~ * ........... ~ ....................... County Tax Map No. 1000 Section ...... (~,,'~...~,. ....... Block ....... .,(~,..,,~7,,. ..... Lot No ......,~,..~ ............ to application dated ...... .,,,~,..~.,..~'~ ................... , 19~..'/..., and approved by the pursuant Building Inspector. ..~~.......~3 ....... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - .1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~. ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approvat of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling ~5~, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 00, over 5 years $]~ 00 ! 4.Vacant Land C.O. $ 20.00 ' , f' . L-~ 5.Updated C.O.//~_ $ 50.00 Date ...[./...~..~. ............ Con t ~ V ' -- New s ruction ..... ~[OId or PreLexisting BuildingI~ ............ Va&nt Land ............. Location of Property/~ '~'~'Jcuse/vo....O..O. ...... . .1~..~1..' .~.... ~ ............... ~,~,~...~?~..~. ...... St~eet l-lam/et Owner or Owners of Property .. ~..'~.~.. .... . .~..,.., C..~..~ ...................... County Tax Map No. 1000 Section ............ Block ......... Lot .......... Subdivision .......................... r ' · '1. · .Filed Map No ........... Lot No .............. PermitNoJ~.~'..~..7T... E~ate of Permit .'~7..l.~.~.l.~TApplicant .. ~.~....~.~.~....(./~.C,. ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate.. Fee Submitted $ ........................ Construction on above described building and plr~it me/~. s alI//' ap~cable ~/~ Rev. 10-10-78 a~d regu tations. UNDATION~s t) UNDATION (2nd) UGH FRAME~ ~LUMBING SULATION PER N. STATE ENERGY CODE -ADDIT'r~NA'L COMMENTS: d EXHAUST FANS THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~tp ~ppltca~ioa No. on filp THIS CB~IFIES THaT DAVID P~SCOE, 5.1100 ~T,?,--H~]N ~OAD, SOU'D{OLD N.Y, ~ ,~y~o~ t~.~u~.~"--- ~ ~ :., ~t. ~ ~ r~. .~t~ ~ examin~ on and found to be in ~mplian~ with the requi~men~s of th~ ~. ~ RXT~ O~N$ 1~ 18 1l 3 SIRVIC~ DISCONNECT S E R V i c DgNTIST CHAIRS & WORK STATION$,2OA-2 PANEI.,BOARDS:i-ll CIR. 125 T~ANSFORMER:i,-O KVA TRACK LIGHTING:-I8 ,lUNGE ARTHUR 6580 NASSAU PT. RD. .UTEHOGUE, NY, 11935 This certlflccrte must not be altered in any manner; return to the office of the Board if. incorrect. Inspectors may be idefltified by thor credentials.' ' COI~' FOIl BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ].000~:{~~0 BUREAU OF ELECTRICITY V ,~1 85 JOHN STREET, NEWYORK, NEWYORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and i~trod~c~ by t~ applicant ~med on the a~ve applic~tlo. .~mber i. ~he premiss of was examined on ~[3b~ ~9 ~ 1~7 and found to be ;. co,npli~nce with the reqtdre.tents ,~f tbls Board. FIXTURE OUTLETS RECEPTACLES 6 SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT 10 ~ 7 DRYERS FURNACE MOTORS APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI*OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S , E R ~-G.F.C.I. T~ACK LIGhtiNG: AWG, OF CC, CQND C NO OF H[-[~G E ~thur V. Jungo 768 11935 GENERAL MANAGER 11 Per-- __ This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials, COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Marc'~ ]8~ ]988 This is to get:if: %ha:, 'the address below has been used. and is being used as mM pi. ace of principlo residence. 511i0 Main Read Southold, New York llg'?.L Ft.!.t[II-,~ AI-di.F.i AlxlAL.YSiS ',:J.[J. OC) Mh'!,l'! I',,'(.]A'(') ~ih.)l I]"t't[')L.D ,, t\1¥ 'L J 9'? 1 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] i~$ULATION FRAMING [~FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~SULATION FRAMING FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~/FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH,~ 3 SETS OF PLANS' · .-- SURVEY ...~K'..., CHECK .......... SEPTIC FORM ............. Approved ..~. .~k~...., 19~.~.. Permit No../..&..i~.~.?..~;. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL ................ MAIL TO: TOWN OF SOUDIO[D. Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and gi¥ing a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. ~'Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~- APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~~ ~d ~-~ ~ (Signature of applicant, or name, i,f a coLTation) . (Mailing address of applicant) State whether applicant is owner, lessee,~chitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................ . ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BK..SUF~FOLK COUNTY LICENSED Builder's License No .... ..~ .~..'.g~..~.~ .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done ............................ ~, ..................... .............. ././. ............................................ House Number Street Hamlet County Tax Map No. 1000 Section ...76 ........... Block ....~ ............. Lot... 7/. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and' occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.. ~.. ~. ~.~ .... ; ...................................... b. Intended use and occupancy ..... .~, .~. ~ · .~.~ · . · ~q...~ .......... '.} ................. 3. Nature of work (check which ap!plicable): New Building ... ' . Addition ..... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... , (Description) 4. Estimated Cost ...................................... Fee ...................................... 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... i ................................................................... If business commercial or mixed occupancy specify nature and extent of each type of use ..................... 7. Dimensions of existing structure?, if any: Front ................ Rear ............... Depth .~ .............. Height ............... Number of Stones ....................... ~ ..... ~. · · ~.' · · Dimensions'of same structure with alterations or additions: Front ............. .... Rear .................. Depth ._,~ ................. !.. Height ........ ... ~ ........... Number of Stories .......... ~ v .......... Dimensi~,~[l,~[l~tire new construction: Front ...... ~./. ........ Rear ........... ' ....Depth ............... Height',"- ~'-~-r' -~-- .... o~..~.(,* ...... N~un}?r of Stories ...... /"' ;¢'~'r .............. ~." L~ ' '~ ................ Size of lot: Front ........ 6..~.. ........ ... Rear. '. ·..~ ................ l~eprn ..................... 10. Date of Purchase ........... ' .................. Name of Former Owner ............................. 11, Zone or use district in which pr~mises are situated ........................ j~/~ ........................... 12. Does proposed construction violgte any zoning law, ordinance or regulation: . ../fo ........................... Will lot be regraded ...... .,~.?. ...... ~ ............ Will excess fill be.re~noved from premises' Yes No 15, · If yes, Southold Town TrUstees Permit may be required. PLO'T DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and inc icate whether STATE OF NEW YORK, . ~'~'~'q COUNTY OF... '/t~' · '~' · '._' ' '~' being duly sworn, deposes and says that he ; the applicant (Name~°ntracflo f individual signing contra t) above named~ is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly authorized to perform or have performed the said work and to ma~ e and file this application; that all statements contained in this application are true to the best of his knowledge and belk f; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 19 f..~. ............. 41./. ....... dayof ............... Notary Public ................... Y HELEN K, DE VOE NOTARY PUBLIC, State of New Yock (Signatu :e of applicant) : No, 4707878, Suffolk ¢ouoty~ 7 Te.n Expires Ma~ch 30, OCCUPANCY OR USE IS UNb~.WFUL WITHOUT CERTIFICATE OF OCCUPANCY HODiF!CA t INN,~ TO RE "~ mx AN]} HANDICAPPED F BATHROOM Lb-LI t Jl. L,II '~ i ', 1'7 ~/ \ \I t USE IS U~qBWFUL WITHOUT CERTiFIC^TE OF OCCUPANCY II · 0 t 0 I it entm~nce \ \ \ \ ,i ] Hmn~Icap \ En~nce pL~?orm do~r ?or hcnd!c.p r~mp max I ~n~j ?Loot 0 O O O I O 0 ! 22,00 U i il UTTi T-r'v J.,.__ Z. i ti !I 8~00 x ' F- I Ii ! III O' ,It F R L-I N T R [] L-J H IR E] 13 ht .... ] h( ]: T C H E: N EL -[] .... ~'] ~_:7_-ZZ ,:*.]' ER t-~E]3R[]EIh't i-'7-1 X I I · L_ J · q Ii ii ,I I G' IIVI~II~II ~ I II Ii